An appraisal of health education policies and programmes towards the promotion of healthcare in Ghana

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One of the key policy objectives under Ghana’s primary health care (PHC) was to attack all diseases that contribute to 80 per cent of all avoidable or preventable deaths and disabilities by 1990. Organising massive health education (HE) campaigns was a priority strategy to achieve this laudable objective which was essentially re-enforcing the centrality of HE among the eight elements of PHC declared by the World Health Organization (WHO) and adopted by member countries in 1978. Unfortunately, after nearly two-decades of PHC implementation the overall epidemiological profile of Ghana is the onset of health in transition, expressed in the preponderance of communicable diseases and emerging non-communicable ones. Poor sanitation has also become an environmental and a health problem of alarming proportions in both urban and rural areas. Public health and social policy advocates have therefore questioned the effectiveness, efficiency and equity about education in general and “health education” in particular, in positively influencing knowledge, attitudes, beliefs, practices and behaviours (KABPB) to facilitate healthy decision making towards health promotion. The study thus set itself to assess the effectiveness and equitable coverage of HE policies and programmes in the promotive, preventive, curative and rehabilitative health services as well as the institutionalized mechanisms for co-ordinating, monitoring and evaluating the programmes and activities. it was an exploratory and descriptive study types coupled with cross-sectional evaluation from the perspectives of healthcare practioners and consumers. Primary data were collected from three sources. The Institutional questionnaire was administered to the Health Education Division in the National Headquarters. Quota sampling technique was used to select 64 healthcare practioners (managers/providers) through the administration of formal questionnaire. Whilst purposive sampling method was employed to select 23 consumers from three different HE delivery settings namely: a school (8), a workplace (8) and a community (7) to conduct a focus group discussion (FGD) each. The primary data were supplemented with secondary information from existing literature and studies on the subject matter. Among the major findings and conclusions of the study are: °Integrated HE counseling and community mobilization strategy that focus on policy determined priority health problems other than family planning, sexually transmitted diseases (STDs) and AIDs, and Immunization is lacking. °Health Education as a service does not have enough professionally trained personnel. Neither is there in place a committed programme of action (POA) to give equal opportunity in terms of training to the existing pool of healthcare practioners in information, education, communication (IEC) and counselling skills °Financial resource commitment by way of programmed budgetary allocation is woefully inadequate Whilst actual allocation to the programme is not sustainable because it is donor driven (i.e. about 70%). Illiteracy, ignorance, poverty and sheer carelessness, facilitated by weak moral family upbringing is greatly responsible for the unhealthy attitudes, behaviour and practices towards healthy living, especially on sanitation and refuse disposal and self medication. Consequently health for-all (HFA) by the year 2000 appears to be a mirage, unless efforts are re-doubled to intensify and disseminate credible health information as consistently as possible to all segments of the society. This calls for the implementation of integrated policy intervention and strategies some of which are: o Rekindling political commitment to the country’s PHC policy; o promoting interest in health education through broader advocacy and lobbying; o strengthening human and institutional capacity building; o Financial resource mobilization and sustainability drive for HE; and °Institutionalizing planning and programming of the nation’s HE programmes and activities. The successful implementation of these proposed interventions would depend on the determined effort and continuing partnership between the government and the private sector, non-governmental organizations (NGO’s) , donor agencies and above all, but more importantly the good people of Ghana to make the dream of health far all a reality.
A thesis submitted to the Board of Postgraduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi, in partial fulfilment of the requirement for the award of the Degree of Master of Science in National Development Policy and Planning, 1997